226 THOMPSON YATES AND JOHNSTON LABORATORIES REPORT 
PRACTICAL APPLICATION OF SEGREGATION TO VARIOUS 
CONDITIONS OF LIFE IN TROPICAL AFRICA 
Since we feel very strongly that the segregation of Europeans is the first step 
in the prophylaxis or malaria in Africa and other tropical regions, we think it desirable 
to show how in practically every condition of life this principle can be applied. 
So far prophylaxis (destructive measures) has been directed entirely against 
the malaria of large towns. If even, however, we could make the large towns of 
West Africa healthy we should still have an enormous fever and death-rate among 
Europeans on the Coast, quite half of whom live in out-stations, and the great majority 
of whom make very frequent tours. Moreover, it is in out-stations that Europeans 
are chiefly in need of protection. Whereas we found that residents in towns enjoyed, 
on the whole, fair health, it was in out-stations that we chiefly found men in the fever- 
stricken and miserable condition so characteristic of tropical Africa. We would point 
out then that something more than anti-malarial measures in large towns is needed if 
much improvement in the health of Europeans is to result. 
It is here that 'segregation ' holds out such prospects of success. Not only is 
the formation of a European quarter in large towns a fundamental law of health, but, 
as we shall show, in out-stations, railway camps, mission stations, in bungalows, in 
tea or coffee gardens, in expeditions, military or otherwise, in ordinary travelling, 
segregation is equally applicable. 
Before malaria is made to decrease among Europeans in Africa it must be 
generally recognized that malaria is an infectious disease, and that it is present in 
practically every native hut. When this is the case men will refuse to allow in their 
compounds squalid grass and palm-leaf huts ; they will cease to build their bungalows 
among or on the outskirts of villages ; they will be extremely careful where they 
sleep when travelling, and it will be the duty of the medical officers of mining camps, 
railways, and military expeditions to absolutely forbid the forming of any camps near 
native huts, or to allow these to spring up in the more permanent camps. 
I. Segregation in Large Towns 
We have two noteworthy instances where in large towns segregation has been 
carried out most effectively, with the result that the two segregated communities, Accra 
(Victoriaborg) and Old Calabar, are notoriously the most healthy on the coast. 
Moreover, in any large town where such complete segregation on a large scale 
is not immediately applicable, the principle should be borne in mind, and as opportunity 
offers, huts should be removed and European houses built in the open. Thus, at 
Lagos, a well-designed quarter could, we feel sure, be gradually formed, and would 
place Lagos in the same category as Accra. At Freetown, we believe arrangements 
are now being made to remove the official quarters to a segregated site on the hills,* 
* Proposed site for European residences in the Sierra Leone hills. Stephens and Christophers. Fifth Report to Malaria 
Committee, Royal Society. Harrison & Sons, London. 
